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Conversion disorder revisited

P Sharma1, S K Chaturvedi

  • 1Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.

Acta Psychiatrica Scandinavica
|October 1, 1995
PubMed
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This study evaluated Lazare's criteria for diagnosing hysteria (conversion disorders). A score of 5 offered high sensitivity but low specificity, suggesting criteria may need refinement, especially regarding "disturbed sexuality" and "secondary gain".

Area of Science:

  • Psychiatry
  • Neurology
  • Psychosomatic Medicine

Background:

  • Hysteria, now often termed conversion disorder, presents diagnostic challenges.
  • Lazare's criteria offer a framework for diagnosing conversion disorders.

Purpose of the Study:

  • To assess the validity and clinical utility of Lazare's criteria in diagnosing hysteria.
  • To explore optimal cut-off scores for Lazare's criteria.

Main Methods:

  • Fifty-four patients diagnosed with hysteria (ICD-9 code 300.1) were studied.
  • Lazare's validation score was calculated for each subject.
  • Sensitivity, specificity, and predictive validity were computed for various cut-off scores.

Main Results:

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  • A cut-off score of 5 yielded 75% sensitivity but only 41% specificity.
  • Individual criteria varied in prevalence (18%-68%), with some needing redefinition (e.g., "disturbed sexuality," "secondary gain").
  • Associations were found between hysteria and organicity, indicated by history, clinical findings, and symptom lateralization.

    • Conclusions:

    • Lazare's criteria show potential but require refinement for accurate conversion disorder diagnosis.
    • The association between hysteria and organicity warrants further investigation.
    • Specific criteria like "disturbed sexuality" and "secondary gain" may need clearer definitions.